Epidemiology Commons^™

Disparities And Protective Factors In Pandemic-Related Mental Health Outcomes: A Louisiana-Based Study, Ariane L. Rung, Evrim Oral, Tyler Prusisz, Edward S. Peters

School of Public Health Faculty Publications

Introduction: The COVID-19 pandemic has had a wide-ranging impact on mental health. Diverse populations experienced the pandemic differently, highlighting pre-existing inequalities and creating new challenges in recovery. Understanding the effects across diverse populations and identifying protective factors is crucial for guiding future pandemic preparedness. The objectives of this study were to (1) describe the specific COVID-19-related impacts associated with general well-being, (2) identify protective factors associated with better mental health outcomes, and (3) assess racial disparities in pandemic impact and protective factors. Methods: A cross-sectional survey of Louisiana residents was conducted in summer 2020, yielding a sample of 986 Black …

Indo-Caribbean Youth And Suicidal Behavior: A Systematic Review, Raul Ruiz Camacho, Shiryn D. Sukhram

Publications and Research

The suicide rates in Guyana, Suriname and Trinidad and Tobago are among the highest in the Americas, containing significant Indo-Caribbean populations that are suggested to be most vulnerable to suicide. This systematic review analyzes the existing literature and identifies knowledge gaps in risk and protective factors against suicide in these countries. The literature search conducted followed PRISMA guidelines using the PubMed and APA PsycInfo databases. The PRISMA flow diagram illustrated that eight scholarly papers were eligible for inclusion. Included literature examined stratified data focused on the aforementioned countries, as well as their Indo-Caribbean adolescent populations. Excluded literature did not mention …

Challenges And Implications For Substance Use And Mental Healthcare Among Under-Resourced Women In The Covid-19 Era, Maria C Mejia, Alicia Kowalchuk, Sandra J Gonzalez, Muktha Nair, Lisa Webb, Nadine Scamp

Faculty, Staff and Students Publications

BACKGROUND: The COVID-19 pandemic exacerbated disparities in mental healthcare and substance use disorder (SUD) treatment access, especially in under-resourced communities. This study aimed to comprehend the experiences of under-resourced women with SUD during the pandemic, their knowledge and attitudes toward it, and its impact on substance use and treatment access.

METHODS: A cross-sectional study included 66 under-resourced women receiving medically managed withdrawal treatment at a community residential SUD center. Data collection occurred between November 2021 and August 2022, utilizing a 75-item instrument covering COVID-19 exposure and its impact on health, substance use, treatment access, vaccination status, beliefs, and knowledge. Descriptive …

Life-Space Mobility And Cognitive Function: The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Emiri Matsuda, Michael Crowe, Virginia J. Howard, Cynthia J. Brown, Madeline R. Sterling, Emily B. Levitan

School of Medicine Faculty Publications

No abstract provided.

Examining The Relationship Between Deafness And Mental Health Status: An Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Brianna Stroud-Williams

Capstone Experience: Master of Public Health

Objective: The objective of the research is to examine the association between mental health status as measured by number of mentally healthy days in the past month and deafness and binge drinking.

Methods: The Behavioral Risk Factor Surveillance System (BRFSS) study was conducted via telephone survey in 50 states, including the District of Columbia and US territories. The sample size is 402,156 participants. Univariate, bivariate, and multivariate regressions, odds ratio, and 95% confidence interval were used to measure the data.

Results: Deaf respondents have 1.56 times the odds of having poor mental health than those who are not deaf. (95% …

Influence Of Medication Assisted Treatment Weaning On Neonatal Abstinence Syndrome And Outcomes Among Infants Born To Women With Opioid Use Disorder, Rakesh Adelli

Electronic Theses and Dissertations

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome exhibited by infants born to mothers with opioid use disorder (OUD). The American College of Obstetricians and Gynecologists and other professional societies endorse opioid agonist pharmacotherapy (MATs) as the optimal treatment for OUD during pregnancy. This study focuses on impact of weaning of MAT drugs on the incidence of NAS and neonatal birth outcomes among babies born to women with opioid exposure.

The study population included eighty-six pregnant women with OUD, divided in to weaning and non-weaning groups based on their choice to wean the MATs during pregnancy. Univariate analysis was …

The Role Of Psychogenic Factors In The Etiopathogenesis Of Autoimmune Disorders In The Oral Cavity, Nadya T. Avramova, Boyko K. Bonev

Journal of Mind and Medical Sciences

Autoimmune disorders (AD) represent a heterogeneous group of multifactorial chronic conditions, which are triggered secondary to the loss of self-antigen tolerance. Their etiology involves genetic, epigenetic, and environmental factors; however, AD cannot be explained by these factors alone. Recent studies have shown increasing stress levels in industrialized countries and also increasing trends in the prevalence of autoimmune diseases. The oral mucosa is extremely responsive to emotional influences such as stress, anxiety and depression. Therefore, oral diseases can appear as a direct expression of emotions or indirectly, due to various psychological mechanisms. The aim of this study is to find and …

Emerging Variants Develop Total Escape From Potent Monoclonal Antibodies Induced By Ba4/5 Infection, Chang Liu, Raksha Das, Aiste Dijokaite-Guraliuc, Daming Zhou, Alexander J Mentzer, Piyada Supasa, Muneeswaran Selvaraj, Helen M E Duyvesteyn, Thomas G Ritter, Nigel Temperton, Paul Klenerman, Susanna J Dunachie, Neil G Paterson, Mark A Williams, David R Hall, Elizabeth E Fry, Juthathip Mongkolsapaya, Jingshan Ren, David I Stuart, Gavin R Screaton

Faculty, Staff and Student Publications

The rapid evolution of SARS-CoV-2 is driven in part by a need to evade the antibody response in the face of high levels of immunity. Here, we isolate spike (S) binding monoclonal antibodies (mAbs) from vaccinees who suffered vaccine break-through infections with Omicron sub lineages BA.4 or BA.5. Twenty eight potent antibodies are isolated and characterised functionally, and in some cases structurally. Since the emergence of BA.4/5, SARS-CoV-2 has continued to accrue mutations in the S protein, to understand this we characterize neutralization of a large panel of variants and demonstrate a steady attrition of neutralization by the panel of …

Willingness To Utilize A Mobile Treatment Unit In Five Counties At The Epicenter Of The Us Rural Opioid Epidemic., Snigdha R. Peddireddy, Melvin D. Livingston Iii, April M. Young, Patricia R. Freeman, Umedjon Ibragimov, Kelli A. Komro, Michelle R. Lofwall, Carrie B. Oser, Michele Staton, Hannah L. F. Cooper

Epidemiology and Environmental Health Faculty Publications

INTRODUCTION: US federal policies are evolving to expand the provision of mobile treatment units (MTUs) offering medications for opioid use disorder (MOUD). Mobile MOUD services are critical for rural areas with poor geographic access to fixed-site treatment providers. This study explored willingness to utilize an MTU among a sample of people who use opioids in rural Eastern Kentucky counties at the epicenter of the US opioid epidemic.

METHODS: The study analyzed Cross-sectional survey data from the Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE) study covering five rural counties in the state. Logistic regression models investigated the …

Evaluating The Oral Health-Related Quality Of Life Among Dental Patients In South India - A Descriptive Study, Dheekshitha P K, Sudeep C B Dr., Sunil P M Dr., Suji M Dr.

Annual Research Symposium

This study aims to evaluate the oral health-related quality of life among dental patients in South India.

Real-World Dispensing Of Buprenorphine In California During Prepandemic And Pandemic Periods, Yun Wang, Alexandre Chan, Richard Beuttler, Marc L. Fleming, Todd Schneberk, Michael Nichol, Haibing Lu

Pharmacy Faculty Articles and Research

Introduction: The opioid overdose crisis in the United States has become a significant national emergency. Buprenorphine, a primary medication for individuals coping with opioid use disorder (OUD), presents promising pharmacokinetic properties for use in primary care settings, and is often delivered as a take-home therapy. The COVID-19 pandemic exacerbated the scarcity of access to buprenorphine, leading to dire consequences for those with OUD. Most existing studies, primarily focused on the immediate aftermath of the COVID-19 outbreak, highlight the challenges in accessing medications for opioid use disorder (MOUDs), particularly buprenorphine. However, these studies only cover a relatively short timeframe. Methods: To …

Availability, Use, And Impact Of Workplace Mental Health Supports During The Covid-19 Pandemic In A Canadian Cohort Of Healthcare Workers, Shannon Ruzycki, Anil Adisesh, Igor Burstyn, Quentin Durand-Moreau, France Labreche, Tanis Zadunayski, Nicola Cherry

Études primaires

We investigated the availability and use of workplace mental health (MH) supports during the COVID-19 pandemic in a Canadian cohort of healthcare workers (HCW) and measured anxiety and depression by the Hospital Anxiety and Depression Scale (HADS) completed at four contacts 2020–2022. Reports were available for 4400 HCW working with patients. Half the HCWs had a clinically significant HADS score at one or more contacts Access to MH supports increased during the pandemic, with 94% reporting access to some workplace support by 2022: 47% had made use of at least one support. 25% of those with high HADS scores used …

An Appalachian Perspective On Suicide: A Focus On West Virginia’S Unique Context, Erin Delaney Caswell

Graduate Theses, Dissertations, and Problem Reports (ETD)

INTRODUCTION: The Appalachian region, spanning 13 states from New York to northern Mississippi, experiences the suicide rates in the United States (U.S.), underscoring a public health crisis exacerbated by persistent socioeconomic challenges. West Virginia (WV), the only state entirely within Appalachia, serves as a focal point for understanding the broader suicide crisis in the region, as WV has the highest suicide rates in the region. Moreover, the state has several unique socioeconomic factors, like increased poverty, lower educational attainment, limited access to healthcare, and a high prevalence of chronic pain and substance that may contribute to elevated rates of suicide. …

Understanding Guardian Perceptions Of Whole-Foods Plant-Based Diets As Interventions In Pediatric Medicine, Vijay R. Luthra

Honors Undergraduate Theses

The obesity epidemic is widespread in American society, often affecting children who bear its consequences innocently. Due to a lack of nutrition knowledge, children rely on caregivers to meet their nutritional needs and instill healthy habits. This study examines parents' attitudes, knowledge, and behaviors, as well as perceived barriers to adopting a whole-foods plant-based diet (WFPD) for their children. Using a modified survey instrument by Morton et al., this study focused on parents and children regarding dietary choices. Participants were recruited from the waiting area of a pediatric clinic at the Medical College of Georgia between April and May 2023. …

Novel Cannabinoid Use Among Young Adults In Lexington, Kentucky, Victoria A. Hamilton

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Purpose: The purpose of this study was to implement a survey to estimate the prevalence of novel cannabinoid use among young adults in Lexington, Kentucky, and to examine modes of use and motivations for novel cannabinoid use. The primary hypothesis of this study was that many respondents would indicate medical reasons for using novel cannabinoids.

Methods: A cross-sectional primary data analysis of 101 young adults in Lexington, Kentucky to determine prevalence of lifetime novel cannabinoid use, past 30-day novel cannabinoid use, mode of use, motivation for use, and related demographic characteristics. Univariate and bivariate analysis were produced using the PROC …

Comparing The Use And Effectiveness Of In-Person And Remote Physical Education Delivery During The Covid-19 Pandemic, Kempson Onadeko, Timothy J Walker, Derek W Craig, Jacob Szeszulski, Andjelka Pavlovic, Laura F Defina, Harold W Kohl

Faculty, Staff and Student Publications

BACKGROUND: Physical Education is a key component to improve youth health, but there is limited information on Physical Education delivery in different formats.

PURPOSE: We compared PE formats (in-person versus remote) across evaluation aspects: weekly minutes; perceived effectiveness; and student-to-teacher ratio.

METHODS: We distributed questionnaires (2020-2021 school year) to school contacts who represented NFL Play 60 FitnessGram

RESULTS: Among 165 schools, 10% (n=17) offered in-person instruction, 31% (n=51) offered remote instruction, and 59% offered both (n=97). Results revealed higher in-person PE minutes (77.2±7.3) compared to remote minutes (67.1±14.6), but results were not significantly different (p=0.19). School contacts reported significantly more …

Self-Perception Of Mental Health, Covid-19 And Associated Sociodemographic-Contextual Factors In Latin America, Pablo Roa, Guillermo Rosas, Gloria Isabel Niño-Cruz, Sergio Mauricio Moreno-López, Juliana Mejía-Grueso, Haney Aguirre-Loaiza, Javiera Alarcón-Aguilar, Rodrigo Reis, Adriano Akira Ferreira Hino, Fernando López, Deborah Salvo, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in …

Work Characteristics, Workplace Support, And Mental Ill-Health In A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Nicola Cherry, Anil Adisesh, Igor Burstyn, Quentin Durand-Moreau, Jean-Michel Galarneau, France Labrèche, Shannon Ruzycki, Tanis Zadunayski

Études primaires

Objective The aim of the study was to identify determinants of mental health in healthcare workers (HCW) during the COVID-19 pandemic. Methods A cohort of Canadian HCW completed four questionnaires giving details of work with patients, ratings of workplace supports, a mental health questionnaire, and substance use. Principal components were extracted from 23 rating scales. Risk factors were examined by Poisson regression. Results A total of 4854 (97.8%) of 4964 participants completed ratings and mental health questionnaires. Healthcare workers working with patients with COVID-19 had high anxiety and depression scores. One of three extracted components, 'poor support,' was related to …

Excess Risk Of Covid-19 Infection And Mental Distress In Healthcare Workers During Successive Pandemic Waves: Analysis Of Matched Cohorts Of Healthcare Workers And Community Referents In Alberta, Canada, Jean-Michel Galarneau, France Labrèche, Quentin Durand-Moreau, Shannon Ruzycki, Anil Adisesh, Igor Burstyn, Tanis Zadunayski, Nicola Cherry

Études primaires

Objectives: To investigate changes in risk of infection and mental distress in healthcare workers (HCWs) relative to the community as the COVID-19 pandemic progressed. Methods: HCWs in Alberta, Canada, recruited to an interprovincial cohort, were asked consent to link to Alberta’s administrative health database (AHDB) and to information on COVID-19 immunization and polymerase chain reaction (PCR) testing. Those consenting were matched to records of up to five community referents (CRs). Physician diagnoses of COVID-19 were identified in the AHDB from the start of the pandemic to 31 March 2022. Physician consultations for mental health (MH) conditions (anxiety, stress/adjustment reaction, depressive) …

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience: Master of Public Health

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …

Modeling, Analysis, And Simulation Of High School Student Mental Health Using Compartmental Models And Physics Informed Neural Networks, Sashwat Ravishankar, Padmanabhan Seshaiyer

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

Houselessness And Syringe Service Program Utilization Among People Who Inject Drugs In Eight Rural Areas Across The Usa: A Cross-Sectional Analysis., April M. Ballard, Dylan Falk, Harris Greenwood, Paige Gugerty, Judith Feinberg, Peter D. Friedmann, Vivian F. Go, Wiley D. Jenkins, P. Todd Korthuis, William C. Miller, Mai T. Pho, David W. Seal, Gordon S. Smith, Thomas J. Stopka, Ryan P. Westergaard, William A. Zule, April M. Young, Hannah L. F. Cooper

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Research conducted in urban areas has highlighted the impact of housing instability on people who inject drugs (PWID), revealing that it exacerbates vulnerability to drug-related harms and impedes syringe service program (SSP) use. However, few studies have explored the effects of houselessness on SSP use among rural PWID. This study examines the relationship between houselessness and SSP utilization among PWID in eight rural areas across 10 states.

METHODS: PWID were recruited using respondent-driven sampling for a cross-sectional survey that queried self-reported drug use and SSP utilization in the prior 30 days, houselessness in the prior 6 months and sociodemographic …

Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton

Master's Projects and Capstones

As the opioid epidemic continues to have devastating effects on our communities, medications to treat opioid use disorder (MOUDs) are severely underutilized especially for adolescents. Unlike adults, minors need parental approval before obtaining MOUDs presenting a key barrier to timely treatment. Being able to treat adolescents as soon as they are ready is critically important for people with OUD, and while cost and other barriers have been addressed in the literature, there is a paucity on how parental consent affects the accessibility of treatment. This paper aims to explore a potential policy in California that addresses the lack of access …

Pediatric Firearm Injury Epidemiology At A Level 1 Trauma Center From 2019 To 2021: Including Time Of The Covid-19 Pandemic, Cynthia Orantes, Hei Kit Chan, Daniel Walter, Summer Chavez, Irma T Ugalde

Faculty, Staff and Student Publications

BACKGROUND: Firearms are a leading cause of death in children. The demand for firearms increased following COVID-19 "stay-at home orders" in March 2020, resulting in record-breaking firearm sales and background checks. We aim to describe the changes in pediatric firearm-related injuries, demographics, and associated risk factors at a Level 1 trauma center in Houston before and during the COVID 19 pandemic.

RESULTS: The total number of pediatric firearm-related injury cases increased during March 15th to December 31st, 2020 and 2021 compared to the same time period in 2019 (104 verses 89 verses 78). The demographic group most affected across years …

Leveraging The Strength Of Collaboration In Rapidly Changing Times: The 29th Annual Conference Of The Health Care Systems Research Network, Michael A. Horberg, Suzanne Simons

Journal of Patient-Centered Research and Reviews

On February 21, 2023, the 29th annual conference of the Health Care Systems Research Network (HCSRN) kicked off at the Sheraton Downtown Denver with more than 320 participants from 20 HCSRN member institutions. Attendees gathered, in person, to reconnect and network during the 3-day conference, which featured the theme Leveraging the Power of the Network in Rapidly Changing Times. This paper highlights takeaways from the conference’s plenary sessions, panel discussions, and abstract presentations.

Temporal Trends And Geographic Variations In Mortality Rates From Tobacco And Firearms In The United States, Sarah A Palumbo, Robert S Levine, Janet D Robishaw, Charles H Hennekens

Faculty, Staff and Students Publications

We explored temporal trends and geographic variations in United States of America (US) mortality rates from smoking and firearms from 1999 to 2019. To do so, we used the publicly available Centers for Disease Control and Prevention (CDC) Wide Ranging Online Data for Epidemiologic Research (WONDER) with Multiple Cause of Death files from 1999 to 2019. Using age-specific rates and ArcGIS Pro Advanced software for Optimized Hot Spot Analyses from Esri, we generated maps of statistically significant spatial clusters with 90-99% confidence intervals with the Getis-Ord Gi* statistic for mortality from smoking-related causes and firearms. These data show temporal trends …

Geospatial Distribution Of Obsessive-Compulsive Disorder Specialists: Understanding Access As A Function Of Distance, Insurance Status, And Neighborhood Socioeconomic Status, Abiodun O Oluyomi, Sophie C Schneider, Catherine Christian, Juan M Alvarez, Orri Smárason, Wayne K Goodman, Eric A Storch

Faculty, Staff and Students Publications

Obsessive-compulsive disorder is an impairing psychiatric condition affecting 1-2% of adults and youth. Cognitive-behavioral therapy with exposure and response prevention (CBT) is an efficacious intervention but requires specialty training and access is often limited. While certain factors are associated with treatment access, one key barrier that has not been explored is the geographic availability of OCD treatment providers. Using integrated geographically-referenced data, we examined the geographic distribution of OCD CBT specialty providers across the state of Texas, with particular attention to the relationship to neighborhood socioeconomic disadvantage, insurance status, and rural versus urban status. We found that specialist providers are …

The Effects Of Covid-19 Lockdown On Social Connectedness And Psychological Distress In Us Adults With Chronic Diseases, Ben King, Omolola E Adepoju, Lechauncy Woodard, Abiodun O Oluyomi, Xiaotao Zhang, Christopher I Amos, Hoda Badr

Faculty, Staff and Students Publications

Lockdown measures enacted in 2020 to control the spread of COVID-19 led to increases in the prevalence of mental health problems. Due to their high-risk status, individuals with chronic diseases may be at increased risk and disproportionately adversely affected by the COVID-19 pandemic. The investigators examined associations between having a high-risk chronic condition, social connectedness, and general distress and COVID-19-specific distress among U.S. adults during the COVID-19 lockdown. Baseline measures of a longitudinal survey collected at the beginning of the pandemic (April to June 2020) were analyzed to identify factors associated with loss of social connectedness from pre- to post-lockdown. …

Drug Ideologies Of The United States, Macy Montgomery

Helm's School of Government Conference - 2021-2024

The United States has been increasingly creating lenient drug policies. Seventeen states and Washington, the District of Columbia, legalized marijuana, and Oregon decriminalized certain drugs, including methamphetamine, heroin, and cocaine. The medical community has proven that drugs, including marijuana, have myriad adverse health side effects. This leads to two questions: Why does the United States government continue to create lenient drug policies, and what reasons do citizens give for legalizing drugs when the medical community has proven them harmful? The paper hypothesizes that the disadvantages of drug legalization outweigh its benefits because of the numerous harms it causes, such as …

Factors Affecting Initiation And Retention Of Medication-Assisted Recovery (Mar) Within A Pilot Pharmacist-Involved Practice Model At A Federally Qualified Healthcare Center (Fqhc) During The Covid-19 Pandemic, Tiffany Nguyen, Thomas Craig Cheetham, Souhiela Fawaz, Richard Beuttler, Sharon Xavioer

Pharmacy Faculty Articles and Research

Background: During the COVID-19 pandemic, opioid-related overdose deaths increased. Although Medication-Assisted Treatment or Recovery (MAT or MAR) is available, initiation and retention rates vary. The goal of this study was to evaluate clinical, demographic, and Social Determinant of Health factors affecting MAR initiation, on-time initiation of medications, and successful retention in the program. The secondary goal was to evaluate the impact of a novel interprofessional practice model incorporating pharmacists. Methods: A retrospective analysis was conducted using electronic health record data from a pilot MAR Program initiated within a California Federally Qualified Healthcare Center. Results: From September 2019 to August 2020, …